An updated review of the molecular mechanisms in drug hypersensitivity

Chun Bing Chen, Riichiro Abe, Ren You Pan, Chuang Wei Wang, Shuen Iu Hung, Yi Giien Tsai*, Wen Hung Chung

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

133 Scopus citations

Abstract

Drug hypersensitivity may manifest ranging from milder skin reactions (e.g., maculopapular exanthema and urticaria) to severe systemic reactions, such as anaphylaxis, drug reactions with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS), or Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). Current pharmacogenomic studies have made important strides in the prevention of some drug hypersensitivity through the identification of relevant genetic variants, particularly for genes encoding drug-metabolizing enzymes and human leukocyte antigens (HLAs). The associations identified by these studies are usually drug, phenotype, and ethnic specific. The drug presentation models that explain how small drug antigens might interact with HLA and T cell receptor (TCR) molecules in drug hypersensitivity include the hapten theory, the p-i concept, the altered peptide repertoire model, and the altered TCR repertoire model. The broad spectrum of clinical manifestations of drug hypersensitivity involving different drugs, as well as the various pathomechanisms involved, makes the diagnosis and management of it more challenging. This review highlights recent advances in our understanding of the predisposing factors, immune mechanisms, pathogenesis, diagnostic tools, and therapeutic approaches for drug hypersensitivity.

Original languageEnglish
Article number6431694
JournalJournal of Immunology Research
Volume2018
DOIs
StatePublished - 2018

Bibliographical note

Publisher Copyright:
Copyright © 2018 Chun-Bing Chen et al.

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